Peri-ictal atrioventricular conduction block in a patient with a lesion in the left insula: Case report and review of the literature

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• 作者：Rainer Surges ; Catherine A. Scott ; Matthew C. Walker
• 关键词：Atrioventricular block ; Asystole ; Sudden unexpected death in epilepsy ; Autonomic function ; Cardiac arrhythmia ; Insula
• 刊名：Epilepsy & Behavior
• 出版年：2009
• 出版时间：October 2009
• 年：2009
• 卷：16
• 期：2
• 页码：347-349
• 全文大小：182 K

文摘

Seizure-induced syncope is uncommon and is usually due to peri-ictal bradycardia and asystole. In contrast, peri-ictal atrioventricular conduction block (AV block) has been reported only rarely. Here, we review the literature on peri-ictal AV block and describe a patient with recurrent episodes of epigastric auras that were occasionally followed by a sensation of dizziness and syncope because of transient third-degree AV block. After installation of a cardiac pacemaker, epigastric auras persisted, whereas the sensation of dizziness and syncope stopped. MRI revealed a lesion in the left insula, leading to the notion that recurrent syncope was most likely due to ictal activity in central autonomic networks.